文永海 廖信祥 王嘉嘉

【摘 要】 目的：观察抱滚法配合特定功能锻炼治疗腰椎滑脱症的临床疗效，为临床提供一种安全、简便、有效的治疗方法。方法：采取平行对照的临床研究方法 将 100例腰椎滑脱症患者随机分为对照组（50例）和观察组（50例）。对照组采用传统的腰椎牵引治疗加卧床休息 观察组采用抱滚法配合特定功能锻炼治疗。观察两组治疗前后腰部疼痛视觉模拟量表（VAS）评分和功能障碍指数（ODI） 评分 参照改善率（RIS）评价临床疗效。结果：对照组总有效率为76.00% 观察组为96.00% 两组比较差异有统计学意义（P<0.05）。治疗后 观察组在改善VAS评分和ODI评分方面 优于对照组（P<0.05）。结论：抱滚法配合特定功能锻炼治疗腰椎滑脱症安全、操作简单、疗效好 具有良好的临床应用前景 值得推广。

【关键词】 抱滚法;功能锻炼;腰椎牵引;腰椎滑脱症

Abstract：Objective To observe the clinical effect of holding and rolling method combined with specific functional exercise in the treatment of lumbar spondylolisthesis， so as to provide a safe， simple and effective treatment.Methods 100 patients with lumbar spondylolisthesis were randomly divided into control group （50 cases） and observation group （50 cases）. The control group was treated with traditional lumbar traction and bed rest，while the observation group was treated with holding roll and specific functional exercise.The visual analogue scale （VAS） score and the dysfunction index （ODI） score of the two groups were observed before and after treatment， and the clinical effect was evaluated with reference to the improvement rate （RIS）.Results the total effective rate was 76.00% in the control group and 96.00% in the observation group. There was a significant difference between the two groups （P<0.05）. After treatment， the VAS score and ODI score of the observation group were better than that of the control group （P<0.05）.Conclusion it is safe， simple and effective to treat lumbar spondylolisthesis with holding rolling method combined with specific functional exercise， which has a good clinical application prospect and is worth popularizing.

Keywords：Holding and Rolling Method; Functional Exercise; Lumbar Traction; Lumbar Spondylolisthesis

腰椎滑脫症是一种引起下腰痛、腰腿痛 双下肢活动异常的疾病 临床上中年以上患者居多 偶见青年患者[1]。腰椎滑脱症根据局部病变可分成5型 其中以退行性腰椎滑脱和峡部裂性腰椎滑脱为主[2] 本研究中病例多为退行性腰椎活脱。 治疗腰椎滑脱症 目前西医大多以手术方法为主治疗 但存在手术治疗费用高、风险大、康复时间久、术后并发症多等缺点。故探寻价廉、高效、安全的中医治疗方法意义重大 患者也较接受此类有效而创伤小的保守治疗方法。 中医药综合疗法多 如正骨、推拿、针灸针刀、中药内服等多种手法在临床运用中取得不错的疗效。抱滚法是治疗腰椎滑脱症的成熟技法 笔者曾采用该法结合推拿手法冶疗50例患者 疗效佳[3]。在此基础上 本研究收集50例腰椎滑脱症患者 对其进行抱滚法配合特定功能锻炼治疗 取得良好效果 现报告如下。……